ABSTRACT
The Japan Society for Oriental Medicine has summarized randomized controlled trials (RCTs) using Japanese traditional (Kampo) medicine in structured abstracts, named “Evidence Reports of Kampo Treatment” (EKAT). In this study, we developed a method of classification based on study design, method of intervention, study aim, journal credibility, and year of publication. Then we classified 416 RCTs in EKAT and examined the current status and evolution of RCTs using Kampo medicine in Japan. Double-blinded RCTs (DB-RCTs) accounted for only 8.9% of the RCTs in EKAT, and 86.5% of DB-RCTs were placebo-controlled. Among the RCTs that aimed to investigate the efficacy of Kampo medicine for diseases without standard Western medical treatment, DB-RCT accounted for 64.9%. In recent years, there have been fewer envelope RCTs and quasi-RCTs, which are prone to an increased risk of bias. The proportion of articles reporting RCTs in journals with an impact factor ( > 0.79 points reported by Journal Citation Reports) has been increasing with each passing year. This implies that the recent research in Kampo medicine has improved its quality and has gained an appreciation in modern medicine. The present study was conducted in “Problem-based Learning” in the 2nd grade of Tohoku University School of Medicine.
ABSTRACT
The patient was a 49-year-old woman. She developed retroperitonitis and retroperitoneal emphysema due to iatrogenic duodenal perforation. We inserted a nasogastric tube into her stomach in order to decompress the gastrointestinal tract, and cefoperazone and proton pump inhibitors were administered intravenously. Her symptoms of retroperitonitis were then reduced. However, she developed enteritis suspected due to MRSA infection complicated by acute respiratory distress syndrome, acute renal failure and shock. We administered vancomycin via nasogastric tube, but her symptoms did not improve, so we added shojokito. She relieved her bowels after the administration of shojokito, and an antipyretic tendency was observed. Her breathing status recovered to normal, her blood pressure was stable, and her general condition gradually improved.<br>In recent years, we have not had many opportunities to perform Kampo treatment for severe infection cases needing hospitalization, but Kampo application has the potential to enhance the efficacy of infection treatments. Thus we advocate the active carrying out of Kampo treatment for patients with intestinal infection.
ABSTRACT
Kampo formulae are selected according to a patient's symptoms. In certain cases the decoctions are modified with additional herbs to provide a suitable treatment. Knowledge of herbs and formulae used clinically in Kampo medicine is essential; however there is a lack of knowledge on how extensively certain herbs are applied. We have analyzed our Kampo outpatient clinic prescriptions for September 2004. The 20 most frequently applied formulae accounted for 60% of all prescriptions. Also, we analyzed our patients' medical backgrounds in relation to the most frequently used 20 prescriptions in September 2004, and the distribution of our patients for each prescription. The distribution of patients for each prescription differed significantly from the distribution of all patients. As a last point, we looked at which herbs were most frequently added to prescriptions. The most frequently added herb was Astragali Radix, followed by Coicis Semen and Aconiti Tuber. We consider this to be significant information for Kampo physicians and pharmacists.
Subject(s)
Medicine, KampoABSTRACT
Laryngeal granulomas which grow in the rear of the vocal cords can be a refractory and recurrent condition, because of various pathogeneses and a lack of established treatment guidelines. We experienced a laryngeal granuloma case which recurred repeatedly, and was resistant to modern medicinal treatment. The laryngeal granuloma recurred after microlaryngosurgery. And though a second microlaryngosurgery and laser cauterization was done, followed by prescription of lansoprazole, tranilast, chlarithromycin and inhalation of fluticasone propionate, the laryngeal granuloma recurred once more. Thus, we tried Kampo medicines at the this time. Hangekobokuto, saishakurikkunshito and keikyososooushimbuto were stopped due to lack of efficacy on the ganuloma, and the Kampo formulation was changed to kairosan. Three weeks after changing formulation, the granuloma was no longer seen with laryngeal fiberscopy. And to-date, recurrence of the granuloma has not been confirmed. This case suggests that fatigue, body weight loss, bilateral Kyokyo-kuman (discomfort of the hypochondrium), bilateral excessive strain of abdominal muscles, pulsation of both the upper and lower navel, and tympanitic sound in upper abdomen may be clinical indications for kairosan.
Subject(s)
Granuloma , Granuloma, Laryngeal , Medicine, KampoABSTRACT
The authors introduce current problems with regard to the male climacteric, or Partial Androgen Deficiency in Aging Males (PADAM) in Japan. They also emphasize the need for an official guideline for diagnosis and treatment, and new testosterone drugs for PADAM.<br>Dysfunction in the aging male is always a quality of life concern. The authors take this opportunity to focus on the possibilities and expectations with Kampo medicine in Japan, while discussing their view of ideal Kampo treatment for PADAM.
ABSTRACT
Patients often complaint about their health, even if nothing is wrong with them upon concise objective examination. The complaints often imply the symptoms reflect more than one organ. Kampo treatment has the advantage of curing several symptoms at the same time, with only one or a few medicines. Kampo medicines comprise Chinese herbal formulations individually tailored to the patient. Therefore, symptom reduction is one of the most essential outcome parameters in Kampo treatment. However, how these subjective symptoms should be quantified, is controversial. The purpose of the current paper is to introduce an evaluation system for subjective symptoms. The system is referred to as Tokyo Women's Medical University Oriental Medicine Research Active Support System (TOMRASS). Apart from subjective symptoms, this database contains physical examination, laboratory data, clinical diagnosis and prescribed medicines, etc. In this study, 2 cases are shown as examples of practical use with TOMRASS use. One is a case with many complaints, which is effective with one medicine, Toki-shigyaku-ka-goshuyu-shokyo-to. The other is a case, which reveals unexpected outcomes with Sho-seiryu-to.<br>The new approach enables us not only to give more consideration to the patient's perspective, but also to differentiate therapeutic implications. The investigation between the subjective quality of life and therapeutic relationship may contribute to further understanding of Kampo treatment.
ABSTRACT
We report a case of a patient with steroid-dependent nephrotic syndrome, who achieved complete remission with a combination of steroid therapy and Bunsho-to. The patient was a 27-year-old female who became aware of edema, and was diagnosed as suffering from focal glomerular sclerosis (glomerulosclerosis) with nephrotic syndrome in November 1992. She responded to steroid therapy, but nephrotic syndrome relapsed frequently after the repeated reduction of steroids. In July 1995, she came to our hospital, and was diagnosed as having a recurrence of nephrotic syndrome. Although the combination therapy of steroid and Kampo formulas, Shinbu-to or Shimotsu-to and/or Keigairengyo-to, was effective, an exacerbation of nephrotic syndrome occurred after steroid therapy was discontinued, in July 1997. The prescription was changed to Bunsho-to, and steroid therapy was re-initiated with 10mg of prednisolone daily. As a result, she achieved complete remission. The steroid therapy could be discontinued in July 1999, and now she has taken Bunsho-to only for 18 months. But the complete remission of nephrotic syndrome has been maintained.
ABSTRACT
A 26-year-old woman who was diagnosed with mild SLE came to our hospital with the complaints about cutaneous eruptions on her face, head and back, as well as alopecia. We treated her with Sho-saiko-to-go-Oren-gedoku-to-ka-Yokuinin. After that, skin symptoms such as erythema, alopecia and photosensitivity disappeared, and an antinuclear antibody, which had shown 640 times at the first medical examination, became negative about two years later. In addition, the skin symptoms did not relapse and the antinuclear antibody rose very little even though the patient received no further medication for the next year. Our reseach found no other case reports of SLE whose antinuclear antibodies became negative only by Kampo treatment and who was treated with Sho-saiko-to-go-Oren-gedoku-to or its modified formulations.<br>Overall, it seemed to be an interesting case, and it suggests that Kampo medicine may be valuable in treating some cases of mild SLE, and may make steroid treatments unnecessary in the early stages of SLE before the diagnosis has been established.
ABSTRACT
Chronic hepatitis C has a high incidence of proceeding to liver cirrhosis, and a natural healing from chronic hepatitis C is extremely rare. We observed a case of chronic hepatitis type C, in which the virus was eliminated after Kampo treatment. The patient was a 37-year-old female who underwent a blood transfusion following delivery of her first child in 1982. In January 1983, she became aware of general malaise, and was diagnosed as having chronic hepatitis. She was treated with Stronger Neo Minophagen C, but her symptoms and laboratory data were unchanged. A liver biopsy disclosed chronic active hepatitis in 1988, and she was transferred to our hospital for Kampo treatment in May. Although the symptoms rapidly disappeared after treatment with the Kampo formulas, Hochu-ekki-to and Keishi-bukuryo-gan, her transamilase values did not change. Her transamilase level decreased gradually after the prescription was changed to Saiko-keishi-to-go-Toki-shakuyaku-san-ryo, and returned to normal after her prescription was changed to Kami-shoyo-san-ryo in May 1996.<br>Concerning HCV-RNA in the serum, in March 1995, when Saiko-keishi-to-go-Toki-shakuyaku-san was administered, the amount of HCV-RNA in the serum was 10<sup>4</sup> Kcopies/ml. But that was less than the detectable sensitivity in April 1998. We believe this to be a case in which elimination of HCV was achieved by Kampo treatment alone.
ABSTRACT
In all but a few cases, the treatment for elderly patients must be conservative owing to the unavoidably poor general condition of the patients.<br>We report on three cases of long-term bedridden patients with acute cholecystitis or cholangitis who were effectively treated with Kampo prescriptions. An 86-year-old male with choledecholithiasis and acute cholangitis responded to Inchin-ko-to. When he repeatedly relapsed after the discontinuance of Kampo treatment, Inchin-ko-to was effective, and Inchin-shingyaku-to successfully improved his general condition. In an 89-year-old male with acute cholecystitis, Dai-saiko-to extracts and Bukuryo-shigyaku-to were effective. An 88-year-old female with cholecystolithiasis and acute cholecystitis responded to Dai-saiko-to and Bukuryo-shigyaku-to.<br>Most elderly patients are Inkyo-sho (Yin-deficient). But, when they are suffering from acute sickness, it is important to treat them according to the principle of “Senkyukokan (treating acute symptoms before treating chronic internal symptoms).” The severe sickness is treated first, and then the mild phase of the disease is treated.
ABSTRACT
We investigated the effects of Kampo treatment on the development and progression of diabetic microangiopathy in 141 patients (95 male and 46 female patients, mean±S.D., 61.3±10.1 years) with non-insulin dependent diabetes mellitus. To this purpose, we examined the severity of diabetic microangiopathy with respect to the duration of suffering from diabetes mellitus as well as the duration of the condition after the commencement of Kampo treatment. We obtained the following results. 1) The significantly lighter the severity of diabetic nephropathy was, the longer its duration under Kampo treatment was. 2) In the group of shorter duration of suffering from diabetes mellitus, although there was no statistical significance, the longer the duration under Kampo treatment was, the lighter the severity of diabetic neuropathy and retinopathy was. But, there was no significant difference in the longer duration of suffering. It was suggested that the combination therapy with Kampo treatment was effective for diabetic microangiopathy.
ABSTRACT
Extract preparations of Shosaiko-to and Keishi-ka-shakuyaku-to were simultaneously prescribed to 34 patients with trigeminal neuralgia. The efficacy of these kampo formulas on painful paroxysms was evaluated two weeks after commencement of formula administration.<br>In 11 out of 19 patients who were also taking carbamazepine (CBZ), dosage reduction or elimination of CBZ administration became possible; from the changes seen in the symptoms, Kampo treatment was thought to be effective in 14 of these cases. Of the 11 cases receiving Kampo alone, reduction in pain or elimination of pain was seen in 8 cases.<br>Excluding 4 cases where effectiveness could not be evaluated, the overall efficacy rate for Shosaiko-to/Keishi-ka-shakuyaku-to was determined to be 73% (22/30 cases).<br>Many basic and clinical studies have verified that Shosaiko-to-go-Keishi-ka-shakuyaku-to acts as an anticonvulsant. There are several common pharmacological characteristics between CBZ, the standard treatment for trigeminal neuralgia, and Shosaiko-to-go-Keishi-ka-shakuyaku-to. The formulas Shosaiko-to and Keishi-ka-shakuyaku-to used by themselves or in combination with CBZ were therefore thought to be a safe and effective option for the treatment of trigeminal neuralgia.